Maternal and child factors associated with early initiation of breastfeeding in Chad : evidence from nationally representative cross-sectional data

Bright Opoku AHINKORAH, Abdul-Aziz SEIDU, Eugene BUDU, Aliu MOHAMMED, Collins ADU, Edward Kwabena AMEYAW, Kwaku KISSAH-KORSAH, Faustina ADOBOI, Sanni YAYA*

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

4 Citations (Scopus)


Background: Early initiation of breastfeeding (EIB) is an inexpensive practice but has a substantial potential to reduce neonatal morbidity. Therefore, this study investigated the maternal and child-related factors associated with EIB and makes recommendations that could help improve the practice in Chad. 

Methods: We used data from the children's recode file of the 2014-2015 Chad Demographic and Health Survey. A total of 3991 women ages 15-49 y who had last-born children in the 2 y preceding the survey were included in our study. The outcome variable for the study was EIB. Both descriptive (frequencies and percentages) and inferential (binary logistic regression) analyses were carried out. All results of the binary logistic analyses are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). 

Results: We found the prevalence of EIB in Chad to be 23.8%. In terms of maternal factors, the likelihood of EIB was high among non-working women (aOR 1.37 [95% CI 1.18 to 1.59]), the richest wealth quintile women (aOR 1.37 [95% CI 1.04 to 1.79]) and non-media-exposed women (aOR 1.58 [95% CI 1.24 to 2.02]) compared with working women, the poorest wealth quintile women and media-exposed women, respectively. EIB was lower among children whose mothers had one to three antenatal care visits (ANC; aOR 0.73 [95% CI 0.61 to 0.87]) and four or more ANC visits (aOR 0.80 [95% CI 0.66 to 0.97]) compared with those who had no ANC visits. With the child factors, EIB was higher among mothers of children who were smaller than average size at birth compared with those of larger than average birth size (aOR 1.47 [95% CI 1.24 to 1.74]). Mothers of children of fifth-order or more births compared with those of first-order births (aOR 1.51 [95% CI 1.07 to 2.12]) and those who were delivered through vaginal birth compared with those delivered through caesarean section (aOR 4.71 [95% CI 1.36 to 16.24]) were more likely to practice EIB. 

Conclusions: Maternal and child-related factors play roles in EIB in Chad. Hence, it is important to consider these factors in maternal and neonatal health interventions. Such initiatives, including training of outreach health workers, health education, counselling sessions and awareness-raising activities on breastfeeding geared towards EIB should be undertaken. These should take into consideration the employment status, wealth quintile, exposure to mass media, size of the baby at birth, ANC visits, parity and delivery method.

Original languageEnglish
Pages (from-to)510-518
Number of pages9
JournalInternational Health
Issue number5
Early online date6 Oct 2021
Publication statusPublished - Sept 2022
Externally publishedYes

Bibliographical note

Authors’ contributions:
BOA, EB and SY contributed to the study design, review of literature, data analysis and manuscript preparation. AS, EB, AM, CA, EKA, KKK and FA critically reviewed the manuscript for intellectual content. SY had final responsibility to submit for publication. All authors read and approved the final manuscript.

The authors thank the MEASURE DHS project for their support and for free access to the original data.

Publisher Copyright:
© 2021 The Author(s). Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.


  • Chad
  • child health
  • early initiation of breastfeeding
  • global health
  • mother
  • newborn


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